The purpose of this study is to describe variability in nursing resource consumption throughout the course of hospitalization and among patients within selected Diagnosis Related Groups (DRG's). Three specific aims are identified: (1) to investigate and establish acceptable levels of reliability for a measure of nursing intensity entitled the Patient Intensity for Nursing Index (PINI); (2) to examine validity of the PINI; and (3) to use the PINI in a descriptive study of resource consumption among hospitalized patients to establish patient need for nursing care and associated nursing costs throughout the course of hospitalization and across selected DRG's. To accomplish these purposes three separate but related substudies are proposed in this four year project. Seven community hospitals have indicated interest in participating in all three phases of the study. The first study involves training Registered Nurses in the use of the Patient Intensity for Nursing Index (PINI) and establishing the intra and interrater reliability of the measure. The second substudy examines construct validity and also reassess reliability following anticipated revisions in the measure. The third and final substudy uses the PINI in a descriptive study of nursing resource consumption. Specifically, the study seeks to examine: the pattern of patient intensity for nursing throughout the course of hospitalization; the variability in patient intensity for nursing within and across selected DRG's; the cost estimates derived from the patient intensity for nursing index; the comparison of those estimates with estimates produced by other measures, and the comparisons of nursing care costs across hospitals.